Strike Force Strikes Houston

HOUSTON — Thirty-two people, including doctors, HME owners
and others, have been indicted for defrauding Medicare of $16
million in a variety of false claims schemes, according to the U.S.
Department of Justice.

In what officials described as “an early morning takedown” on
Wednesday, Medicare Fraud Strike Force agents executed 12 search
warrants at health care businesses and homes across the Houston
area and made arrests in Houston, New York, Boston and
Louisiana.

Seven indictments unsealed July 29 in the U.S. District Court
for the Southern District of Texas charge the defendants in fraud
schemes related to false billing for “arthritis kits,” power
wheelchairs and enteral feeding supplies. According to the
indictments, the products involved were not medically necessary or
often never provided. In some cases, indictments allege that
beneficiaries were deceased at the time they supposedly received
the items.

A Strike Force document lists Houston area HME providers and
related companies named in the indictments as Onward Group
Healthcare, dba Onward Medical Supplies; KO Medical; Luant &
Odera, operating as Tonni Medical Equipment and Supplies; Memorial
Medical Supply; Family Healthcare Services; Trucare Medical
Equipment Services; and Sefan Healthcare Services.

The Medicare Fraud Strike Force—a multi-agency team
including federal, state and local investigators—was launched
in March 2007, initially targeting South Florida. A year later,
operations expanded to Los Angeles. Detroit was added in March
2009, followed by Houston in July. To date, the Strike Force has
obtained indictments of more than 293 individuals and organizations
that collectively have billed Medicare for more than $674 million,
according to a DOJ release.

“Our Medicare Strike Force is striking back against health care
fraud in all its forms and wherever it occurs,” Deputy Attorney
General David Ogden said in the release. “We will stop fraud as
it’s happening, using real-time data analysis of Medicare billing
records.”

In a statement issued Thursday, the American Association for
Homecare said it “strongly supports” the Strike Force
crackdown.

Last year, the association proposed a 13-point Medicare
Anti-Fraud Legislative Plan to stop fraud in the HME sector and
has urged its adoption by Congress. Among the provisions in the
legislative proposal are more rigorous quality standards, increased
penalties for fraud, mandated site inspections for new providers
and real-time claims analysis.

“We have zero tolerance for illegal activity,” said AAHomecare
President Tyler Wilson. “Eliminating fraud and abuse will benefit
patients and seniors by lowering costs and increasing quality of
care. We urge Congress to adopt new regulations, like those
outlined in our 13-point plan, and we support tough enforcement
actions, like those carried out by the Medicare Fraud Strike
Force.”

In May, HHS Secretary Kathleen Sebelius and Attorney General
Eric Holder announced a joint initiative to reduce Medicare and
Medicaid fraud called the Health Care Fraud Prevention &
Enforcement Action Team, or HEAT. The takedown in Houston was the
third major sweep since the effort began.